Illicit drug use affects individuals, families and the broader Australian community. These harms are numerous and include:

  • health impacts such as burden of disease, death, overdose and hospitalisation
  • social impacts such as violence, crime and trauma
  • economic impacts such as the cost of health care and law enforcement
  • some specific population groups are at greater risk of experiencing disproportionate harms associated with illicit drug use, including young people, people with mental health conditions and people identifying as gay, lesbian, bisexual, transgender or intersex (Department of Health 2017). 

Definition of illicit drug use

‘Illicit use of drugs’ covers the use of a broad range of substances, including:

  • illegal drugs—drugs prohibited from manufacture, sale or possession in Australia, including cannabis, cocaine, heroin and amphetamine-type stimulants
  • pharmaceuticals—drugs available from a pharmacy, over-the-counter or by prescription, which may be subject to misuse (when used for purposes, or in quantities, other than for the medical purposes for which they were prescribed). Examples include opioid-based pain relief medications, opioid substitution therapies, benzodiazepines, steroids, and over-the-counter codeine (not available since 1 February 2018)
  • other psychoactive substances—legal or illegal, used in a potentially harmful way—for example, kava; synthetic cannabis and other synthetic drugs; inhalants such as petrol, paint or glue (Department of Health 2017).

Each data collection cited on this page uses a slightly different definition of illicit drug use; see the relevant report for information.

How common is illicit drug use?

According to the 2019 National Drug Strategy Household Survey (NDSHS), an estimated 9.0 million (43%) people aged 14 and over in Australia had illicitly used a drug at some point in their lifetime (including the non-medical use of pharmaceuticals) and an estimated 3.4 million (16.4%) had used an illicit drug in the previous 12 months. This was similar to proportions in 2016 (43% and 15.6%, respectively) but has increased since 2007 (38% and 13.4%, respectively) (Figure 1).

In 2019, the most common illicit drug used in the previous 12 months was cannabis (11.6%), followed by cocaine (4.2%) and ecstasy (3.0%) (Figure 1). A number of changes were reported in the recent use of illicit drugs between 2016 and 2019, including increases in the use of:

  • cannabis (from 10.4% to 11.6%)
  • cocaine (from 2.5% to 4.2%)
  • ecstasy (from 2.2% to 3.0%)  
  • hallucinogens (from 1.0 % to 1.6%)
  • inhalants (from 1.0% to 1.4%)
  • ketamine (from 0.4% to 0.9%) (Figure 1) (AIHW 2020).

Overall, in 2019, an estimated 900,000 people (4.2%) aged 14 and over used a pharmaceutical drug for non-medical purposes in the previous 12 months, a decline from 4.8% (an estimated 1 million people) in 2016 (AIHW 2020). Between 2016 and 2019, the proportion of people using ‘pain-killers and opioids’ for non-medical purposes declined from 3.6% to 2.7%. This decline is likely to be due to a reclassification of medications containing codeine that was implemented in 2018. Under the change, drugs with codeine (including some painkillers) can no longer be bought from a pharmacy without a prescription. The proportion of people using codeine for non-medical purposes has halved since 2016, from 3.0% to 1.5% in 2019. 

In 2016, pain-killers and opioids used for non-medical purposes were the second most commonly used illicit drug in the previous 12 months after cannabis, but in 2019, they were fourth, after cannabis, cocaine and ecstasy (AIHW 2020).

Due to the changes in recent use of a number of illicit drugs between 2016 and 2019, meth/amphetamines are no longer in the top 5 illicit drugs most likely to be used in the previous 12 months. Meth/amphetamine use has been declining since it peaked at 3.4% in 2001 and stabilised in 2019 (1.4% in 2016 and 1.3% between 2016 and 2019).

To better understand illicit drug use in Australia, it is important to consider the frequency of drug use and not just the proportion of people that have used a drug in the previous 12 months. Some drugs are used more often than others, and the health risks of illicit drug use increase with the frequency, type, and quantity of drugs used (Degenhardt et al. 2013). While cocaine and ecstasy were used by more people in the previous 12 months, most people used these drugs infrequently with 57% of people who used cocaine and 51% of people who used ecstasy reporting they only used the drug once or twice a year in the 2019 NDSHS. Conversely, monthly or more frequent drug use was more commonly reported among people who had used cannabis (50%) or meth/amphetamines (33%).
 

The graph shows the percent of recently used selected illicit drugs by people aged 14 and over between 2001 and 2019. The chart shows a declining trend from 2001 to 2007, in the recent use of any illicit drug (from 16.7% to 13.4%), recent cannabis use (from 12.9% to 9.1%) and recent hallucinogen use (from 1.1% to 0.6%). Since 2007, there have been slight increases in the use of any illicit drug, recent cannabis use, recent hallucinogen use and recent inhalant use. This graph also shows that recent meth/amphetamine use and ecstasy use have been trending downward, while cocaine use has trended upward since about 2004. Between 2016 and 2019, recent use of almost all illicit drug types in the chart increased, including cannabis (from 10.4% to 11.6%), cocaine (from 2.5% to 4.2%), ecstasy (from 2.2% to 3.0%), hallucinogens (1.0% to 1.6%) and inhalants (from 1.0% to 1.4%). Pain-killers/pain-relievers and opioids decreased between 2016 and 2019 (from 3.6% to 2.7%).

Figure 1 data table (136KB XLSX)

Health impact

Deaths

Drug-induced deaths are defined as those that can be directly attributable to drug use, as determined by toxicology and pathology reports (see Glossary for more information).

Analysis of the AIHW National Mortality Database (Figure 2) showed that:

  • in 2019, 1,865 deaths were drug-induced, equivalent to 7.4 per 100,000 population, age-standardised—one of the highest rates on record, but still lower than the rate in 1999 of 9.1 deaths per 100,000 population
  • opioids was the most common drug class present in drug-induced deaths over the past decade (4.6 per 100,000 population in 2019). Opioids include the use of a number of drug types, including heroin, opiate-based analgesics (such as codeine and oxycodone) and synthetic opioid prescriptions (such as tramadol and fentanyl)
  • in 2019, benzodiazepines were the most common single drug type present in drug-induced deaths (3.3 per 100,000 population) (benzodiazepines are included in the drug class ‘depressants’)
  • over the past decade, drug-induced deaths were more likely to be due to prescription drugs than illegal drugs, and there has been a substantial rise in deaths with a prescription drug present. For synthetic opioids (including fentanyl and tramadol) in particular, the rate has increased from 0.3 per 100,000 population (57 deaths) in 2010 to 0.9 (231 deaths) in 2019.

The graph shows the rate of drug-induced deaths by drug class from 1997 to 2019; including antidepressants, depressants, antipsychotics, non-opioid analgesics and opioids. The chart shows the rate of drug-induced deaths declined between 1999 and 2002 (9.1 to 4.8 deaths per 100,000 population). This decrease was largely driven by a fall in drug-induced deaths between 1999 and 2002 where an opioid was present (6.5 to 2.5 deaths per 100,000 population). Since 2006, the rate of drug-induced deaths has started to increase, this increase is primarily driven by opioids, depressants and antidepressants.

Figure 2 data table (136KB XLSX)

Burden of disease

According to the Australian Burden of Disease Study 2015, illicit drug use contributed to 2.7% of the total burden of disease and injury in 2015 (AIHW 2019). This included the impact of opioids, amphetamines, cocaine, cannabis, and other illicit drug use, as well as unsafe injecting practices. The rate of total burden of disease and injury attributable to illicit drug use increased 18% between 2003 and 2015 (AIHW 2019).

Opioid use accounted for the largest proportion (37%) of the illicit drug use burden, followed by amphetamine (21%), cocaine (11.4%) and cannabis (8.3%) use. An estimated 27% of the burden was from poisoning and 18.2% was from diseases contracted through unsafe injecting practices (AIHW 2019). See Burden of disease.

Hospitalisations

The National Hospital Morbidity Database contains information on drug-related hospitalisations (see Glossary for more information).

In 2018–19, 61,780 of the 11.5 million hospitalisations in Australia’s public and private hospitals had a drug-related (excluding alcohol) principal diagnosis (0.5% of all hospitalisations).

The total number and rate of drug-related (excluding alcohol) hospitalisations rose from 56,578 in 2014–15 to 61,780 in 2018–19 (from 244.3 to 250.6 per 100,000 population). The rise in drug-related hospitalisations has largely been driven by increases associated with amphetamines and other stimulants (49.1 hospitalisations per 100,000 population in 2014–15 to 62.7 hospitalisations per 100,000 population in 2018–19).

Between 2017–18 and 2018–19, the rate of drug-related hospitalisations also increased for multiple drug use (from 17.8 to 21.7 per 100,000 population) and cocaine (from 4.1 to 4.7 per 100,000 population). Conversely, the rate of drug-related hospitalisations decreased between 2017–18 and 2018–19 for antiepileptic, sedative-hypnotic and antiparkinsonism drugs (from 38.4 to 36.5 per 100,000), non-opioid analgesics (from 32.2 to 29.2 per 100,000), opioids (including heroin, opium, morphine and methadone) (from 34.3 to 33.3 per 100,000) and cannabinoids (25.5 to 24.0 per 100,00) (Figure 3; Man et al. 2021c).

See Alcohol risk and harm for information on drug-related hospitalisations where alcohol was the drug.
 

The graph shows the rate of hospitalisations by drug of concern between 2013–14 and 2017–18. This includes antidepressants and antipsychotics, benzodiazepines, cannabinoids, methamphetamines, non-opioid analgesics, opioids and sedatives and hypnotics. The chart shows that the rate of drug-related hospitalisations for antidepressants and antipsychotics, benzodiazepines, cannabinoids, methamphetamines, non-opioid analgesics, and sedatives and hypnotics has been slowly increasing since 2013–14. The rate of hospitalisations for opioids has remained fairly stable since 2013–14. 

Figure 3 data table (136KB XLSX)

Non-fatal overdose

Data from the 2020 Illicit Drugs Reporting System (IDRS) and Ecstasy and related Drugs Reporting System (EDRS) include rates of self-reported overdose:

  • of 2020 IDRS participants, 11% reported a non-fatal heroin overdose in the past 12 months (Peacock et al. 2021b)
  • of 2020 EDRS participants, 18% reported experiencing a non-fatal stimulant overdose in the past 12 months (Peacock et al. 2021a).

Treatment

The Alcohol and Other Drug Treatment Services National Minimum Data Set reported 130,065 (59%) treatment episodes in 2019–20 where the principal drug of concern (PDOC) was an illicit drug (this includes episodes where prescription drugs and volatile solvents were the PDOC) (AIHW 2021).

Amphetamines were the most common principal illicit drug of concern in 2019–20, having surpassed cannabis for the first time in 2015–16. Between 2010–11 and 2019–20, closed treatment episodes for amphetamines as a principal drug of concern increased from around 12,600 to 61,000 and increased for cannabis from around 31,500 to 40,300 episodes (AIHW 2021). See Alcohol and other drug treatment services.

Social impact

The social impacts of illicit drug use are pervasive and include criminal activity, engagement with the criminal justice system and victimisation. For example:

  • 2 in 5 participants of the 2020 IDRS (40%) and 1 in 3 participants of the 2020 EDRS (33%) reported participating in criminal activities. The most common criminal activities were property crime and selling and/or dealing of drugs (Peacock et al. 2021b; Peacock et al. 2021a)
  • in 2019, 1 in 10 (10.5%) people aged 14 and over had been a victim of an illicit drug-related incident (experiencing verbal abuse, physical abuse or being put in fear) in the previous 12 months, an increase from 9.2% in 2016 (AIHW 2020)
  • in 2018–19, 1 in 5 (21%) victims and 12% of offenders had consumed illicit drugs or non-therapeutic levels of pharmaceutical drugs before a homicide incident (Bricknell 2021).

Priority populations

The National Drug Strategy 2017–2026 specifies priority populations who have a high risk of experiencing direct and indirect harm as a result of drug use, including young people, people with mental health conditions and people identifying as gay, lesbian, bisexual, transgender or intersex (Department of Health 2017).

Young people

Young people are susceptible to permanent damage from alcohol and other drug use as their brains are still developing, which makes them a vulnerable population (Department of Health 2017).

Young people (aged 14–29) in 2019 were less likely to have used an illicit drug in the previous 12 months than young people in 2001—with a particularly large difference seen among teenagers and people in their 20s. For example, in 2001, 28% of 14–19 year olds had used an illicit drug in previous 12 months, but by 2019, this was 16%.

In 2019, people aged 20–29 were the most likely to have used an illicit drug in the previous 12 months (31%), a similar proportion to 2016 (28%). There have been significant changes in the types of drugs used by people in their 20s. Ecstasy use among people in their 20s declined from 12.0% in 2004 to 7.0% in 2016 then rose again to 9.8% in 2019. This was the first time an increase was reported in ecstasy use for people in this age group in over a decade, with use returning to a similar level reported in 2001 (10.4%) (Figure 4). Cocaine use among people in their 20s was at its highest level in 2019. Much of the rise in cocaine use among people in this age group occurred between 2016 and 2019—from 4.3% in 2001 to 6.9% in 2016 and up to 12.0% in 2019. On the other hand, use of methamphetamines among people in their 20s is at its lowest level since 2001 (declined from 11.2% in 2001 to 2.4% in 2019). See Health of young people.
 

The graph shows the proportion of people aged 20–29 that recently used cocaine, ecstasy and meth/amphetamine by people aged 20–29 between 2001 and 2019. The chart shows a decline in recent ecstasy use by people aged 20–29 between 2007 and 2016 (from 11.2% to 7.0%) and an increase in 2019 (9.8%). Recent cocaine use by people aged 20–29 was highest in 2019, the largest increase was between 2016 and 2019 (from 6.9% to 12.0%). Recent meth/amphetamine use by people aged 20–29 was at its lowest in 2019, declining from a peak of 11.2% in 2001 to 2.4% in 2019.

Figure 4 data table (136KB XLSX)

People with mental health conditions

There is a complex relationship between illicit drug use and mental health conditions. However, it is difficult to determine to what extent drug use causes mental health problems, and to what degree mental health problems give rise to drug use (Loxley et al. 2004).

In 2019, the NDSHS showed that the proportion of self-reported mental health conditions was higher among people aged 18 and over who reported the use of illicit drugs in the previous 12 months (26%) than those who had not used an illicit drug over this period (15.2%) (AIHW 2020). For example, mental conditions were reported by:

  • 31% of people who recently used meth/amphetamine (compared with 16.6% of non-users)
  • 27% of people who recently used cannabis (compared with 15.4% of non-users)
  • 22% of people who recently used ecstasy (compared with 16.7% of non-users)
  • 22% of people who recently used cocaine (compared with 16.6% of non-users) (AIHW 2020).

The EDRS reported an increase in self-reported mental health conditions between 2014 and 2020 (from 28% to 52%) (Peacock et al. 2021a). See Physical health of people with mental illness.

People identifying as gay, lesbian or bisexual

People who identify as gay, lesbian, bisexual, transgender or intersex can be at an increased risk of licit and illicit drug use. These risks can be increased by a number of issues such as stigma and discrimination, familial issues, fear of discrimination and fear of identification (Department of Health 2017). There is limited data available on substance use by people identifying as gay, lesbian, bisexual, transgender, intersex or queer. The NDSHS provides substance use estimates by sexual identity for people identifying as gay, lesbian or bisexual, however it does not include estimates for people identifying as transgender or intersex (AIHW 2020). 

The NDSHS has consistently shown that the proportion of people reporting illicit drug use has been higher among people who identify as gay, lesbian or bisexual than among heterosexual people—40% compared with 15.4% had used an illicit drug in the previous 12 months in 2019. After adjusting for differences in age, in comparison to heterosexual people, gay, lesbian or bisexual people were:

  • 9.0 times as likely to use inhalants in the previous 12 months
  • 3.9 times as likely to have used meth/amphetamines in the previous 12 months
  • 2.6 times as likely to have used ecstasy in the previous 12 months (AIHW 2020).

The types of illicit drugs people had used in the last 12 months varied quite considerably by a person’s sexual orientation and it is important to note that there are differences in substance use between people who identified as gay or lesbian and people who identified as bisexual (AIHW 2020).

Where do I go for more information?

For more information on illicit drug use, see:

Visit Illicit use of drugs for more on this topic.

References

AIHW (Australian Institute of Health and Welfare) 2019. Australian Burden of Disease Study 2015: interactive data on risk factor burden. Web report. Canberra: AIHW.

AIHW 2020. National Drug Strategy Household Survey 2019. Drug statistics series no. 32. Cat. no. PHE 270. Canberra: AIHW.

AIHW 2021. Alcohol, tobacco and other drugs in Australia 2019–20 report. Web report. Cat no. HSE 250. Canberra: AIHW. Viewed 14 May 2021.

Bricknell S, 2021. Homicide in Australia 2018–19. Canberra: Australian Institute of Criminology.

Degenhardt L, Whiteford HA, Ferrari AJ, Baxter AJ, Charlson FJ et al. 2013. Global burden of disease attributable to illicit drug use and dependence: findings from the Global Burden of Disease Study 2010. The Lancet 382(9904):1564–74.

Department of Health 2017. National Drug Strategy 2017–2026. Canberra: Department of Health. Viewed 13 October 2019.

Loxley W, Toumbourou J, Stockwell TR, Haines B, Scott K, Godfrey C et al. 2004. The prevention of substance use, risk and harm in Australia: a review of the evidence. Canberra: The National Drug Research Institute and the Centre for Adolescent Health.

Man N, Chrzanowska A, Sutherland R, Degenhardt L, Peacock A et al. 2021c. Trends in drug-related hospitalisations in Australia, 1999-2019 | NDARC - National Drug and Alcohol Research Centre (unsw.edu.au). Sydney: NDARC, UNSW Sydney.

Peacock A, Karlsson A, Uporova J, Gibbs D, Swanton R, Kelly G et al. 2021a. Australian Drug Trends 2020: Key Findings from the National Ecstasy and Related Drugs Reporting System (EDRS) Interviews. Sydney: National Drug and Alcohol Research Centre (NDARC), UNSW Sydney.

Peacock A, Uporova J, Karlsson A, Gibbs D, Swanton R, Kelly G, et al. 2021b. Australian Drug Trends 2020: Key Findings from the National Illicit Drug Reporting System (IDRS) Interviews. Sydney: NDARC, UNSW Sydney.